BACKGROUND:: Cerebral cavernous malformations are brain vascular malformations associated with intracranial hemorrhage. It is unclear if pregnancy is a risk factor for hemorrhage, yet there is speculation it may be. OBJECTIVE:: To compare the risk of clinically significant hemorrhage during pregnancy and non-pregnancy. METHODS:: 186 patients from the University of Toronto Vascular Malformations Study Group were enrolled. The obstetrical history of each patient was collected and matched to their neurological history from the records of the study group. All hemorrhagic events occurring during childbearing years were associated with either a defined pregnancy risk period or non-pregnancy period. Patients were also asked to recall advice they received from healthcare professionals regarding risk of hemorrhage in pregnancy. RESULTS:: Among our patient population there were 349 pregnancies (283 live births) and 49 hemorrhages during childbearing years, three of which were during pregnancy but none during delivery or within six week post-partum. The hemorrhage rate for pregnant women was 1.15% (0.23-3.35, 95% CI) per person-year and 1.01% (0.75-1.36, 95% CI) per person-year for non-pregnant women. Relative risk of pregnancy 1.13 (0.34 - 3.75, 95% CI), P = 0.84. Neurosurgeons and obstetricians were the source of most hemorrhage risk advice. The majority of neurosurgeons suggested that the risk was unchanged but the obstetricians were divided. Four patients never conceived and two others undertook contraception because of the advice they received. CONCLUSION:: The risk of intracranial hemorrhage from cerebral cavernous malformations is likely not changed during pregnancy, delivery, or post-partum.